LOGAN SQUARE FOOT CENTER PC NPI 1417126301

NPI Information

LOGAN SQUARE FOOT CENTER PC is a durable medical equipment medical supplies in Chicago, IL. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. LOGAN SQUARE FOOT CENTER PC NPI is 1417126301. The provider is registered as an organization entity type.

The provider's business location address is:

2831 N MILWAUKEE AVE
CHICAGO, IL
ZIP 60618-403
Phone: (773) 772-4440
Fax: (773) 772-4461

The provider's authorized official is Garry S. Isenstadt .
The authorized official title is Doctor and has the following contact phone number (773) 772-4440.

The enumeration date for this NPI number is 2/25/2008 and was last updated on 9/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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